Occupational Therapy Janet Gunter, Occupational Therapist: And this is our pretend airplane, so climb aboard. Rowan: I don’t want to play it anymore. Janet Gunter: Well, you said you were going to get a hundred animals. We didn’t get all our animals, so let’s get our animals and then you can be done. Thank you. Florence Clark, PhD Chair, USC Division of Occupational Science & Occupational Therapy: Sensory Integration as an intervention was really developed by Dr. A. Jean Ayres, who had studied at the Brain Research Institute at UCLA. She started out as an occupational therapist. She became a psychologist. She then studied at the Brain Research Institute. Janet Gunter: Come get more friends. Rowan: It’s in the air. Janet Gunter: It’s flying, so come pick up your friend. Hurry, hurry! He wants to come too! Dr. Florence Clark: We’re really among the earliest providers of intervention for children with autism. Some of the comprehensive educational programs like TEACCH and even the Denver Model enfold sensory approaches that are very informed by what work that occupational therapists have been doing. In other settings there is an interdisciplinary team, and a lot of the clinics have speech pathology, they have an ABA specialist, they have occupational therapists, and in those settings the intent is to put together the best customized plan for each child based on that child’s needs. Rowan: He’s happy. He’s happy. Janet Gunter: Oh! They’re very excited to start the adventure. Suzan Rafeii Speech and Language Pathologist: There are children with autism that are nonverbal that we know, we’re working on getting more functional communication, and Rowan is an example of a child that’s a lot higher functioning. He, he has a lot of words. His vocabulary is very strong, and so what we want to focus on and hinder on is taking advantage of that and making him more appropriate in a natural context and remaining on the task. Janet Gunter: Are you going to land on the moon? Rowan: Yes. I’m going to go. I’m going to go. Janet Gunter: Rowan, is it your turn? O.K. Let’s go. Janet Gunter Occupational Therapist: And then I’d also say that what we’d like is that Rowan is definitely very opinionated, which is fantastic, because we’re able to use his intrinsic motivation as a support to help increase his skill level with what his ideas for play are. Rowan: It’s a, it’s a, sorry, it’s a rocket ship. Janet Gunter: Oh, it’s a rocket ship. Everybody off the rocket ship. Rowan: No, no, no, it’s not ready yet. Janet Gunter: Not ready to land it? Rowan: No, no, it’s not ready! It’s not ready! It’s not ready! Janet Gunter: The first activity we did was too challenging, I think, and so we, I think it was really difficult for him to do it, so he kept stopping the movement on the swing. It was difficult for him to tolerate the movement as well as coordinate how to move the swing. Rowan: It’s not the bumpy one! Janet Gunter: It’s not the bumpy one? O.K., is it the smooth one? Rowan: Yes. Janet Gunter: O.K. Ready? Hold on. Janet Gunter: I first met Rowan about a year ago, and it was really difficult for me to get him to engage in anything that wasn’t his choice of activity, and he avoided anything that was challenging to him. He basically flitted from one activity to another, and that is a big problem for him at school and home in his daily life, um that affects his ability to function with others and within his different environments. He also had significant difficulties with participating in the moving equipment and possibly at times feeling posturally insecure, and so his ability to climb on the different swings that you saw today was a great improvement. Rowan with Janet Gunter: Three, two, one! Janet Gunter: Crash into the blue rocks! Janet Gunter: Rowan’s difficulties with processing sensory information aren’t, uh, the typical ones that you hear of in terms of extreme examples, where he might run away from touch or, you know, cry if he’s touched or, uh, scream if he’s moved on a swing. His are more of a difficulty with modulation of the sensory information related to the movement experience as well as to the tactile experience. Suzan Rafeii: Occupational therapy overlaps with speech therapy. There are a lot of similar goals that we have: keeping the conversation on what we were talking about and having appropriate social skills. So how do we communicate with another? We take turns and what kind of responses we have with one another. Rowan: Then, that’s how we get there. That’s how we get there. Janet Gunter: If you want to use the secret door, you can . . . Rowan: How do we get it? How do we use the secret door? We . . . Janet Gunter: Yes. Janet Gunter: The other difficulties that he has are related to hand skills and fine motor activities and, um, typical activities that he would have to do as a student, so writing, um, building with tools and using his hands to create things. Janet Gunter: Do you want to go up the slide? Rowan: Yes. Janet Gunter: Oh, wow, that’s very tricky. Janet Gunter: We did a lot of deep pressure input, which tends to be more calming and regulating, because my focus was to help him to self-regulate and sustain engagement. Janet Gunter: Yes. Dr. Florence Clark: The sense of the core self, the sense that I’m a self really means I have a body scheme, and I know where my body begins and ends, and I also have a spatial, visual scheme about the environment. And on top of that I have ideas about objects and what they do and what I can do with these objects. Rowan: Yes, I’ll get it. Janet Gunter: Ah, you got it. Rowan: Let me get the crosser.